A Redwood City family is grappling with unexpected medical bills totaling over $6,900 after their daughter participated in a COVID-19 research study at Stanford Health Care. The family believed they were contributing to important research aimed at alleviating the symptoms and long-term risks associated with COVID-19, but their goodwill has led to significant financial stress.
In 2022, Maria Fraboni’s daughter tested positive for COVID-19. Shortly thereafter, she received an unsolicited call from Stanford Health Care’s Infusion Center, inviting her to join a study purportedly focused on reducing COVID symptoms. The call promised that the study, which involved three transfusions, would be completely free of charge. Trusting the information provided, Fraboni’s daughter agreed to participate.
A few months later, the family received two bills from Stanford Health Care, amounting to over $6,900. Shocked and dismayed, Fraboni attempted to resolve the issue with the hospital. A patient relations manager informed her that the balance was considered the patient’s responsibility due to a deductible.
“I was like, that’s just not right! They contacted you first of all,” Fraboni recounted, expressing her frustration. She pointed out that, according to state law at the time, the COVID treatment should have been fully covered by their health plan. The patient relations representative confirmed that it should have been free and advised Fraboni to file a claim with their insurer, Cigna.
Fraboni submitted the necessary paperwork to Cigna twice but to no avail. She faced weeks of unanswered calls and emails as she sought to recover the unexpected costs. “I kept calling Cigna… I couldn’t get a live person,” she lamented. This process has left her feeling exhausted and frustrated.
Stanford Health Care responded to inquiries, stating, “Our patient relations team is working with the patient.” Meanwhile, Fraboni’s daughter was informed by the collection agency that paying the bill immediately would result in a reduced amount. In a state of fatigue from the entire ordeal, she paid the revised bill of over $3,900.
Cigna later clarified that while California law mandated full coverage for COVID-19 testing and certain preventive services without cost-sharing as of April 2022, it did not extend this requirement to therapeutics, such as Veklury, at that time. They expressed regret that some clinical trial teams had provided inaccurate information regarding coverage to participants.
However, a notice from the California Department of Insurance contradicts Cigna’s statement, asserting that health insurers regulated by the state were indeed required to cover the treatment free of charge during the period of Fraboni’s daughter’s transfusions. “For me it’s not about the money, it’s just the principle… her trying to do a nice thing that just turned into this nightmare,” Fraboni remarked.
In light of the ongoing confusion, inquiries were made to both Cigna and Stanford Health Care about waiving the fees associated with the study. On a recent afternoon, Stanford Health Care provided an update, indicating that their Patient Relations team is in the process of refunding the amount paid by the patient as a courtesy. The family can expect notification within the next couple of weeks. They also confirmed that no outstanding bill remains with Stanford.
Cigna reiterated its stance, emphasizing that customers should always verify coverage details prior to receiving treatment. They encouraged patients to reach out through various channels, including their customer service hotline and mobile app.
This incident highlights the complexities and challenges faced by patients navigating healthcare systems, especially when participating in studies intended to advance medical research.
